Utilization Manager Jobs in San Diego
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San Diego
Job Description:
Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM). These will be completely remote positions, working entirely from the Nurse’s home. The Nurse will be reviewing cases, educating...
icims.com -
Macpower Digital Assets Edge Private Limited-San Diego
JOB SUMMARY: Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which...
resume-library.com -
Molina Healthcare-San Diego
Education
Bachelor's Degree in Nursing
Preferred Experience
Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.
Effective verbal and written...
Alameda Health System-San Diego
off plans
Role Overview:
Alameda Health System is hiring The Director of Utilization Management holds a critical role encompassing operational oversight, strategic planning, compliance, and collaboration. Their responsibilities span from...
tiptopjob.com -
Molina Healthcare-San Diego
Management and knowledge of Interqual / MCG guidelines.
Preferred License, Certification, Association
Active, unrestricted Utilization Management Certification (CPHM).
To all current Molina employees: If you are interested in applying for this position...
International SOS Government Medical Services-San Diego
lives.
Key Responsibilities
Participate in Utilization Management/Case Management meetings to review and identify opportunities to improve treatment provided and recommend corrective action when problems exist.
Participate in the provision...
resume-library.com -
Molina Healthcare-San Diego
hospice facilities
Working knowledge of Utilization Management processes
Preferred License, Certification, Association
Active, unrestricted Certified Case Manager (CCM)
To all current Molina employees: If you are interested in applying...
San Diego
Education & Requirements
• Two (2) or more years of individual or combined experience in pharmacy, hospital, or drug benefit related quality assessment, utilization management and/or provider liaison duties OR a minimum of one (1) year Managed Care...
icims.com -
PIH Health-San Diego
to implement key strategies.
Required Experience
Required:
Minimum of 3 years of Case Management/Utilization Management or Quality Management experience Minimum of 3 years leadership/management experience Knowledge and understanding of Utilization...
tiptopjob.com -
San Diego
This Licensed Practical Nurse will provide utilization management activities in the Referral Management Center.
• Maximize family time with no weekend, Holiday, or on-call requirements
• Maintain work-life balance with guaranteed 8-hour shifts
• Take advantage of our...
icims.com -
San Diego
OR two (2) years of case management/utilization management required.
Skills & Knowledge:
• Knowledge of workers' compensation laws and regulations
• Knowledge of case management practice
• Knowledge of the nature and extent of injuries, periods...
icims.com -
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